Cognitive Stress Research Articles

Prevalence of psychosocial work factors and stress and their associations with the physical and mental health of hospital physicians: A cross-sectional study in Lithuania.

A negative psychosocial work environment causes stress to the physicians of healthcare institutions, which affect their physical and mental health. This study aimed to evaluate the prevalence of psychosocial work factors and stress and their associations with the physical and mental health of hospital physicians in the Kaunas region of Lithuania. A cross-sectional study was performed. It was based on a questionnaire survey, which contained the Job Content Questionnaire (JCQ), three scales of Copenhagen Psychosocial Questionnaire (COPSOQ), and Medical Outcomes Study Short Form-36 (SF-36) health survey. The study was carried out in 2018. A total of 647 physicians completed the survey. Multivariate logistic regression models were performed by using the stepwise method. In the models potentially, confounding factors such as age and gender were controlled. In our study, the dependent variables were stress dimensions, and the independent variables were psychosocial work factors. The analysis showed that a quarter of surveyed physicians were classified as having low job skill discretion and decision-making authority, and the support of supervisors was weak. Approximately one-third of the respondents had low decision latitude, low co-worker support, and high job demands, and felt insecure at work. Job insecurity and gender were found to be the strongest independent variables for general and cognitive stress. The support of the supervisor was found as a significant factor in the case of somatic stress. Better evaluation of mental health was related to job skill discretion and co-workers' and supervisors' support, but it did not affect physical health. The confirmed associations suggest that looking at work organization factors, reducing exposure to stress, and increasing perception of the psychosocial environment can be linked to better subjective health evaluation.

Comparing the Feasibility and Acceptability of a Virtual Human, Teletherapy, and an e-Manual in Delivering a Stress Management Intervention to Distressed Adult Women: Pilot Study.

Virtual humans (VHs), teletherapy, and self-guided e-manuals may increase the accessibility of psychological interventions. However, there is limited research on how these technologies compare in terms of their feasibility and acceptability in delivering stress management interventions. We conducted a preliminary comparison of the feasibility and acceptability of a VH, teletherapy, and an e-manual at delivering 1 module of cognitive behavioral stress management (CBSM) to evaluate the feasibility of the trial methodology in preparation for a future randomized controlled trial (RCT). A pilot RCT was conducted with a parallel, mixed design. A community sample of distressed adult women were randomly allocated to receive 1 session of CBSM involving training in cognitive and behavioral techniques by a VH, teletherapy, or an e-manual plus homework over 2 weeks. Data were collected on the feasibility of the intervention technologies (technical support and homework access), trial methods (recruitment methods, questionnaire completion, and methodological difficulty observations), intervention acceptability (intervention completion, self-report ratings, therapist rapport, and trust), and acceptability of the trial methods (self-report ratings and observations). Qualitative data in the form of written responses to open-ended questions were collected to enrich and clarify the findings on intervention acceptability. Overall, 38 participants' data were analyzed. A VH (n=12), teletherapy (n=12), and an e-manual (n=14) were found to be feasible and acceptable for delivering 1 session of CBSM to distressed adult women based on the overall quantitative and qualitative findings. Technical difficulties were minimal and did not affect intervention completion, and no significant differences were found between the conditions (P=.31). The methodology was feasible, although improvements were identified for a future trial. All conditions achieved good satisfaction and perceived engagement ratings, and no significant group differences were found (P>.40). Participants had similar willingness to recommend each technology (P=.64). There was a nonsignificant trend toward participants feeling more open to using the VH and e-manual from home than teletherapy (P=.10). Rapport (P<.001) and trust (P=.048) were greater with the human teletherapist than with the VH. The qualitative findings enriched the quantitative results by revealing the unique strengths and limitations of each technology that may have influenced acceptability. A VH, teletherapy, and a self-guided e-manual were found to be feasible and acceptable methods of delivering 1 session of a stress management intervention to a community sample of adult women. The technologies were found to have unique strengths and limitations that may affect which works best for whom and in what circumstances. Future research should test additional CBSM modules for delivery by these technologies and conduct a larger RCT to compare their feasibility, acceptability, and effectiveness when delivering a longer home-based stress management program. Australian New Zealand Clinical Trials Registry ACTRN12620000859987; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=380114&isReview=true.

Augmented reality-assisted gesture-based teleoperated system for robot motion planning

Purpose The study proposed a human–robot interaction (HRI) framework to enable operators to communicate remotely with robots in a simple and intuitive way. The study focused on the situation when operators with no programming skills have to accomplish teleoperated tasks dealing with randomly localized different-sized objects in an unstructured environment. The purpose of this study is to reduce stress on operators, increase accuracy and reduce the time of task accomplishment. The special application of the proposed system is in the radioactive isotope production factories. The following approach combined the reactivity of the operator’s direct control with the powerful tools of vision-based object classification and localization. Design/methodology/approach Perceptive real-time gesture control predicated on a Kinect sensor is formulated by information fusion between human intuitiveness and an augmented reality-based vision algorithm. Objects are localized using a developed feature-based vision algorithm, where the homography is estimated and Perspective-n-Point problem is solved. The 3D object position and orientation are stored in the robot end-effector memory for the last mission adjusting and waiting for a gesture control signal to autonomously pick/place an object. Object classification process is done using a one-shot Siamese neural network (NN) to train a proposed deep NN; other well-known models are also used in a comparison. The system was contextualized in one of the nuclear industry applications: radioactive isotope production and its validation were performed through a user study where 10 participants of different backgrounds are involved. Findings The system was contextualized in one of the nuclear industry applications: radioactive isotope production and its validation were performed through a user study where 10 participants of different backgrounds are involved. The results revealed the effectiveness of the proposed teleoperation system and demonstrate its potential for use by robotics non-experienced users to effectively accomplish remote robot tasks. Social implications The proposed system reduces risk and increases level of safety when applied in hazardous environment such as the nuclear one. Originality/value The contribution and uniqueness of the presented study are represented in the development of a well-integrated HRI system that can tackle the four aforementioned circumstances in an effective and user-friendly way. High operator–robot reactivity is kept by using the direct control method, while a lot of cognitive stress is removed using elective/flapped autonomous mode to manipulate randomly localized different configuration objects. This necessitates building an effective deep learning algorithm (in comparison to well-known methods) to recognize objects in different conditions: illumination levels, shadows and different postures.

스트레스 반응 수준에 따라 인지스트레스와 호흡훈련이 정신건강과 심박변이도에 미치는 영향

Purpose: The present study investigated whether stress and ventilator ytraining (VT) have different effects on psychophysiological responses according to the magnitude of the stress response.BR Method: Participants were twenty-three college students with a high-tsress response and twenty-three with a low-stress response. Psychological tests (depression, axniety, stress response, and resilience), heart rate variability (SDNN, RMSSD, total power, LF, HF, and LF/HF ratio), and visual analogue scale (anxiety, stress, confidence, and relaxation) were measured at rest, after cognitive stress, and after ventilatory training.BR Results: High-stress group showed higher depression, trait, state anxiety, and lower resilience compared to the low-stress group. The high-stress group showed higher VAS anxiety and stress, and lower relaxation and self-confidence scores. Computational task increaseds tress and decreased heart rate and RMSSD. VT not only lowered anxiety and stress, increased relaxation and confidence, but also increased SDNN, RMSSD, total power, and LF. However, there was no significant d ifference between the stress response groups in all variables before and after the stress task and ventilatory training.BR Conclusion: VT seems to be an effective way to restore the balance of th aeutonomic nervous system caused by stress.

Relaxing effects of music and odors on physiological recovery after cognitive stress and unexpected absence of multisensory benefit.

Several studies have described, often separately, the relaxing effects of music or odor on the autonomic nervous system (ANS) activity. Only a few studies compared the presentation of these stimuli and their interaction within a same experimental protocol. Here, we examined whether relaxing music (slow-paced classical pieces) and odor (lavender essential oil) either presented in isolation or in combination would facilitate physiological recovery after cognitive stress. We continuously recorded the electrocardiogram to assess the high-frequency component of heart rate variability (HF-HRV), an index of parasympathetic activity, and electrodermal activity (EDA), an index of sympathetic activity, 10min before, during and 30 min after a cognitive stress (i.e., completing timely constrained cognitively demanding tasks) in 99 participants allocated to four recovery conditions (control N=26, music N=23, odor N=24, music+odor N=26). The stressing event triggered both a significant increase in EDA and decrease in HF-HRV (compared to baseline). During the recovery period, the odor elicited a greater decrease in EDA compared to an odorless silent control, whereas no difference in HRV was observed. Conversely, during this period, music elicited a greater increase in HF-HRV compared to control whereas no difference in EDA was observed. Strikingly, in the multimodal music+odor condition, no beneficial effect was observed on ANS indexes 30 min after stress. Overall, our study confirms that both olfactory and musical stimuli have relaxing effects after stress on ANS when presented separately only, which might rely on distinct neural mechanisms and autonomic pathways.

Salivary Cortisol Dynamics After Mild Traumatic Brain Injury.

To assess mild traumatic brain injury (mTBI)-related alterations in baseline (resting) salivary cortisol and cortisol reactivity to cognitive and exercise stressors, which are frequently encountered during mTBI rehabilitation and recovery. Persons with mTBI were recruited from a level 1 trauma center emergency department. Uninjured controls (UCs) were recruited from the community. Participants were 37 individuals with mTBI and 24 UCs. All patients with mTBI were enrolled at 7 ± 3 days post-injury, met the American Congress of Rehabilitation Medicine definition of mTBI, and had no acute intracranial findings on clinical neuroimaging (if performed). A prospective cohort study design was used. All participants provided saliva samples 10 times during each of 2 visits spaced 3 weeks apart (1 week and 1 month post-injury for the mTBI group). Each visit included baseline saliva sampling and sampling to evaluate reactivity to a cognitive stressor (Paced Auditory Serial Addition Test) and physical stressor (Buffalo Concussion Treadmill Test [BCTT]). Natural log-transformed salivary cortisol was measured by enzyme immunoassay. Cortisol was predicted using a linear mixed-effects model by group (mTBI and UC), visit (1 week and 1 month), and saliva sample. Mean salivary cortisol was higher in the mTBI group (1.67 nmol/L [95% CI 1.42-1.72]) than in controls (1.30 nmol/L [1.12-1.47]), without an mTBI × time interaction. At 1 week, the mTBI group had greater cortisol reactivity in response to the BCTT. Higher cortisol in individuals with mTBI at 1 week and 1 month post-injury extends previous findings into the subacute recovery period. Furthermore, the mTBI group demonstrated a greater cortisol response to mild-to-moderate aerobic exercise (BCTT) at 1 week post-injury. Given the increasing role of exercise in mTBI rehabilitation, further research is warranted to replicate these findings and identify the clinical implications, if any, of enhanced hypothalamic-pituitary-adrenal axis responses to exercise in civilians with recent mTBI.

The Impact of Information About COVID-19 on the Endocrine Stress System and Cognitive Distortions.

The coronavirus disease 2019 (COVID-19) pandemic is one of the major health concerns worldwide affecting not only human physical health but also contributing to the development of many mental disorders including impairment of the cognitive function. It is highly conceivable that elevation of the stress hormones, i.e., glucocorticoids and catecholamines, due to the infection, as well as the presence of psychosocial stressors, such as COVID-19 information, play a critical role in the development of these disorders. In the present study, the potential impact of exposure to COVID-19 information on the cognitive distortion and stress levels was analyzed in a population of 32 first-year medical sciences students using the stress assessment questionnaire (SAQ) and the posttraumatic cognitions inventory (PTCI) surveys. Both surveys demonstrated no acute change in the stress and post-traumatic cognition levels between medical sciences students who were either exposed or not to information about COVID-19. Interestingly, analysis of the stress and cognition points across the first and second measurements of the SAQ categories revealed a significant change in the control group but not in the experimental group. In addition, there was no significant difference among groups when considering the time*group factor. To conclude, we found that exposure to information about COVID-19 did not contribute acutely to cognitive distortion and stress levels among participating students. The previous exposure to COVID-19-related information from media and living during the COVID-19 pandemic era might have enhanced the awareness of the students to the situation.

The Effectiveness of Internet-Based Cognitive Behavioral Therapy as a Preventive Intervention in the Workplace to Improve Work Engagement and Psychological Outcomes: Protocol for a Systematic Review and Meta-analysis

Mental health has become an increasingly significant issue in the workplace.Non-health care workers are experiencing increased levels of psychological symptoms in their workplaces, especially during the COVID-19 pandemic, which limited social interactionsand health service access.These conditions have a negative effect on employees' mental health and may also be associated with work-related outcomes, such as reduced levels of work engagement.Cognitive behavioral therapy (CBT)is one ofthe most effective methods used for treating workers with mental illness and preventing work-related psychological outcomes. The delivery of internet-based CBT (iCBT) has been established as a result of both technological improvements that have influenced health promotion and prevention components, and limited social contact and health service access. The purpose of this systematic review is to synthesize the best available evidence concerning the preventive effect of iCBT on employees. A systematic search will be conducted across 12 electronic databases,including a hand search for main journals and reference lists. Randomized controlled trials testing the effects of iCBT on psychological outcomes and work engagement among employees will be eligible. Initial keywords will cover the concepts of employees, workers, non-health care personnel, internet-based, web-based, eHealth cognitive behavioral interventions, stress, depression, anxiety, and work engagement, and then a full search strategy will be developed. Following titles, abstracts and the full text will be screened for assessment against the inclusion criteria for the review. Search results will be fully reported and presented per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two independent reviewers will screen and extract data, appraise methodological quality using the Cochrane risk-of-bias assessment tool, and assess overall quality of evidence with the Grading of Recommendations Assessment, Development, and Evaluation approach. A random effects meta-analysis and standardized mean differences using review manager software will be applied to synthesize the effect of iCBT based on similar outcomes. This protocol was registered in the International Prospective Register of Systematic Reviews in March 2022 and isnow an ongoing process. The data will be analyzed in August 2022, and the review process should be completed by December 2022. All included studies will be synthesized and presented to demonstrate the effectiveness of iCBT in decreasing psychological distress and optimizing work engagement outcomes among employees. According to the findings of this study, iCBT therapies will be used to promote mental health concerns such as depressive symptoms, anxiety, psychological distress, stress, insomnia, and resilience among non-health care professionals. In addition, the results will be used to ensure the policy related to reducing psychological distress and optimizing work engagement in the workplace. PRR1-10.2196/38597.

Heart rate variability responses to cognitive stress in fibromyalgia are characterised by inadequate autonomous system stress responses: a clinical trial

Fibromyalgia (FM) is associated with sympathetically dominant dysautonomia, but the connection between dysautonomia and FM symptoms is unclear. Dysautonomia can be analysed with heart rate variability (HRV) and it has been proposed that FM patients comprise subgroups with differing profiles of symptom severity. In our study, 51 female FM patients aged 18 to 65 years and 31 age-matched healthy female controls followed a 20-min protocol of alternating relaxation and cognitive stress (mental arithmetic). Heart rates and electrocardiograms were registered. The HRV measures of heart rate (HR), mean interval between heart beats (RRmean), root mean squared interval differences of successive beats (RMSSD), and the standard deviation of intervals between normal heart beats (SDNN) were analysed with generalized linear modelling. Features in HRV reactivity which differed between FM patients and controls were used to cluster the FM patients and cluster characteristics were analysed. FM patients had higher baseline HR (72.3 [SD 12.7] vs 64.5 [7.80], p < 0.001) and lower RRmean (0.844 [0.134] vs 0.934 [0.118], p = 0.002), compared with controls. They also reacted to repeated cognitive stress with an attenuated rise in HR (− 4.41 [95% CI − 7.88 to − 0.93], p = 0.013) and attenuated decrease of RRmean (0.06 [95 CI 0.03 to 0.09], p < 0.001), compared with controls. Clustering of FM patients by HRV reactivity resulted in three clusters characterised by (1) normal levels of HRV and HRV reactivity with low levels of depressive mood and anxiety, (2) reduced levels of HRV and impaired HRV reactivity with increased levels of depressive mood and high levels of anxiety, and (3) lowest HRV and most impaired HRV reactivity with the highest scores for depressive mood and anxiety. Our results show that FM patients have lower HRV than healthy controls and their autonomous reactions to cognitive stress are attenuated. Dysautonomia in FM associates with mood disturbance.Trial registration ClinicalTrials.gov (NCT03300635). Registered October 3 2017—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03300635.

Virtual Training on Stress Management for the Mothers of Children with Disabilities in the United Arab Emirates.

Parenting children with disabilities has consistently been reported to be associated with stress, and even more so among mothers who are primary caregivers. In non-Western contexts such as the United Arab Emirates (UAE), there is a dearth of research on maternal mental health in relation to raising children with disabilities and related mitigation strategies. During the COVID-19 pandemic (2020-2021), the Federal Government of the UAE used the Save the Child's Stress Checklist to assess the stress levels of 635 mothers who were raising children with disabilities in the northern part of the country. In the pre-test, an estimated 6% (36/635) of the mothers were found to be experiencing high levels of stress. Consequently, virtual stress management training was conducted, and 12 of the 36 mothers completed the full training. Wilcoxon's ranked test showed a reduction in their total, physical, emotional and cognitive stress at the end of the training. This study demonstrates the pressing need for ongoing training programmes to improve the mental health of mothers of children with disabilities in the UAE and similar contexts.

Exposure to a Virtual Reality Mass-Casualty Simulation Elicits a Differential Sympathetic Response in Medical Trainees and Attending Physicians.

Previous studies have demonstrated the use of virtual reality (VR) in mass-casualty incident (MCI) simulation; however, it is uncertain if VR simulations can be a substitute for in-person disaster training. Demonstrating that VR MCI scenarios can elicit the same desired stress response achieved in live-action exercises is a first step in showing non-inferiority. The primary objective of this study was to measure changes in sympathetic nervous system (SNS) response via a decrease in heart rate variability (HRV) in subjects participating in a VR MCI scenario. An MCI simulation was filmed with a 360º camera and shown to participants on a VR headset while simultaneously recording electrocardiography (EKG) and HRV activity. Baseline HRV was measured during a calm VR scenario immediately prior to exposure to the MCI scenarios, and SNS activation was captured as a decrease in HRV compared to baseline. Cognitive stress was measured using a validated questionnaire. Wilcoxon matched pairs signed rank analysis, Welch's t-test, and multivariate logistic regression were performed with statistical significance established at P <.05. Thirty-five subjects were enrolled: eight attending physicians (two surgeons, six Emergency Medicine [EM] specialists); 13 residents (five Surgery, eight EM); and 14 medical students (six pre-clinical, eight clinical-year students). Sympathetic nervous system activation was observed in all groups during the MCI compared to baseline (P <.0001) and occurred independent of age, sex, years of experience, or prior MCI response experience. Overall, 23/35 subjects (65.7%) reported increased cognitive stress in the MCI (11/14 medical students, 9/13 residents, and 3/8 attendings). Resident and attending physicians had higher odds of discordance between SNS activation and cognitive stress compared to medical students (OR = 8.297; 95% CI, 1.408-64.60; P = .030). Live-actor VR MCI simulation elicited a strong sympathetic response across all groups. Thus, VR MCI training has the potential to guide acquisition of confidence in disaster response.

Rodent Model Preclinical Assessment of PEGylated Block Copolymer Targeting Cognition and Oxidative Stress Insults of Alzheimer's Disease.

Misfolded peptide amyloid beta (Aβ42), neurofibrillary tangles of hyper-phosphorylated tau, oxidative damage to the brain, and neuroinflammation are distinguished determinants of Alzheimer's disease (AD) responsible for disease progression. This multifaceted neurodegenerative disease is challenging to cure under a single treatment regime until the key disease determinants are traced for their sequential occurrence in disease progression. In an early report, a novel side-chain tripeptide containing PEGylated block copolymer has been tested thoroughly in vitro and in silico for the early inhibition of Aβ42 aggregation as well as degradation of preformed Aβ42 fibril deposits. The present study demonstrates a preclinical assessment of the PEGylated block copolymer in colchicine-induced AD-mimicking rodent model. The colchicine-induced Wistar rats receiving an intranasal delivery of the block copolymer at a daily dosage of 100µg/kg and 200µg/kg body weights, respectively, for 14days manifested a notable attenuation of behavioral deficit pattern, oxidative stress, and neurotransmitters' deficiency as compared to the untreated ones. The current study also reports the ameliorative property of the PEGylated compound for progressive neuroinflammation and decreased mitochondrial bioenergetics in astrocytoma cell line, viz., U87. A closer look into the drug mechanism of action of a compact 3D PEGylated block copolymer confirmed its disintegrative interaction with Aβ42 fibril via in silico simulation. The results obtained from this study signify the potential of the novel PEGylated block copolymer to ameliorate the cognitive decline and progressive oxidative insults in AD and may envision a successful clinical phase trial. The amelioration of disease condition of colchicine-induced AD rat. Initially the rat has given colchicine via stereotaxic surgery which led to a mimicking condition of AD including neuronal death in hippocampal CA1 region. After recovery from the surgery, the rat was treated with the PEGylated block copolymer through intranasal delivery, and this has led to the decrease in neuronal death in hippocampal CA1 region. The mechanism of drug action has shown by the separation of monomer chains of Aβ42.

Potential of Augmented Reality in Optimization of Military Libraries Services

Augmented Reality (AR) overlays the information of virtual objects on actual surfaces and enhances learners’ experience. As AR is becoming an increasingly important part of military training, military libraries can provide a cohesive experience using the latest advent of AR and core library science components to meet the military community’s ever-dynamic needs. Since augmented reality is in a developing phase, this paper aims to know the potential of AR Military libraries service by conducting a systematic review of papers published in the Scopus database. AR in military libraries can enhance learning interest, perception of situation awareness, and adequate decision support. AR can offer great solutions to facilitate the controlling capabilities of military trainees and reduce cognitive load and stress. Its application in military libraries includes information filtering, 3D visualization, and extending digital threads. However, despite many limitations of AR usage, its applicability in military libraries can improvise the extensive pool of knowledge and experience to deal with warfare situations to improve capabilities of reaction and response in real-time war situations to improve the controlling capabilities of military trainees include tactical simulation, judgment in operations, assignment, and military simulations.

Investigating the relationship between mindfulness, stress and creativity in introductory engineering design

Abstract Mindfulness-based interventions (MBIs) for engineering design are promising for their stress management, cognition and well-being benefits. Prior work concluded that engineering design is stressful and that each engineering design stage has unique stressors. This non-randomized study investigated the effect of an MBI on students’ cognitive stress and final design creativity during a multistage, hands-on design assessment. Data were collected using surveys, project deliverables and follow-up interviews. While no significant increase was found in students’ measured state mindfulness due to the intervention, students in the MBI condition were more likely to perceive the intervention positively compared to students in the control condition (alternative use tasks). Students in both conditions were found to have similar levels of state stress, which indicates that the MBI had no observable effect on students’ measured stress during design. Although students in the MBI condition were found to produce higher-quality final designs, there were no differences in design creativity or novelty. When data were clustered to identify types of student experiences, state mindfulness was found to meaningfully contribute, but state stress was not. Future research should continue to investigate MBIs in engineering design as a potential approach to improve design education and outcomes.

Cognitive performance, burden and stress in aged caregivers of older adults with and without cognitive impairment.

To compare the cognitive performance, burden and stress of aged caregivers of older adults with and without signs of cognitive impairment. A cross-sectional and quantitative study conducted with 205 aged caregivers of older adults with signs of cognitive impairment and 113 aged caregivers of older adults without signs of cognitive impairment treated in Primary Health Care. They were evaluated for sociodemographic characteristics, cognition, burden, and stress. Descriptive (Kolmogorov-Smirnov test) and comparative (Student's t-test and Pearson's χ² test) analyses were performed. Aged caregivers of older adults with signs of cognitive impairment were older, had lower schooling levels, and a higher percentage of daily care hours compared to the aged caregivers of older adults without signs of cognitive impairment. Regarding cognitive performance, the means were lower for all domains. In addition, this same group had higher scores, with a statistically significant difference for perceived stress and burden. Aged caregivers of older adults with signs of cognitive impairment showed lower cognitive performance, as well as higher burden and stress levels. These findings guide the planning of interventions with aged caregivers in the Primary Health Care.

The presence of moral distress among critical care nurses in Saudi Arabia

Background: Moral distress (MD) was first defined as a situation in which one knows the right thing to do, but institutional constraints make it nearly impossible to pursue the right course of action. This can be even more challenging within the critical care context as critical the care context imposes physical, emotional, and cognitive stressors on critical care nurses. Methodology: A descriptive quantitative approach was followed, and the critical care units of two tertiary hospitals in two provinces in Saudi Arabia were included in the study, yielding a cluster sample size of 361 critical care nurses. Data were collected using the MD Scale-Revised, for which reliability and validity have been established. Results: The mean total MD experienced by respondents was 77.15 ± 58.32, representing a low level of MD. The statement that nurses indicated as causing the most distress was “follow the family's wishes to continue life support even though I believe it is not in the best interest of the patient” with 5.98 ± 5.04. Furthermore, 17.5% (n = 63) of nurses had considered leaving their positions because of MD. MD was the highest in the Emergency department with 102.12 ± 70.59; as experience increased by 1 year, the MD score increased by 11.56. Conclusion: When dealing with issues related to futile care, critical care nurses experience MD. Therefore, future research is required to develop appropriate interventions with which to address critical care-related MD.

Physiological Effects of Using Citrus Mint Flavored Mouthwash

This study aimed to investigate the effect of flavored mouthwash on peripheral and cardiac autonomic nervous system activity. In a within-subject experimental design, 10 male and 10 female healthy adults went through two types of mouthwashes, one was with citrus mint flavor and another was with spice mint flavor, right after performing a 20-minute calculation task given as a cognitive stressor. Along with subjective evaluation, skin conductance and electrocardiogram was recorded throughout the experiment. Although there was no difference in the subjective stress levels between the two conditions, the level of skin conductance decreased more remarkably and significantly during the recovery period when the participants used citrus mint mouthwash. The findings suggest that a particular flavored mouthwash may provide physiological effect on user regardless of its subjective sensation and the citrus mint type mouthwash might be better suited for use in need of a relaxation.

Association between job control and psychological health in middle-level managers.

The present study analyses the effect of job control at work on psychological stress for Indian Middle-Level Managers (MLMs) of a public telecom organisation. Two hundred ten MLMs from different parts of India have participated in the survey. Three dimensions of job control visualize control over work (CoW), control over working time (CoT1) and control over working days (CoT2), were considered. The validity and reliability were confirmed using Factor and reliability analysis. A Binary Logistics Regression (BLR) was performed to find the effect of job control on behavioural, somatic and cognitive stress controlling for age, gender, and experience. The Odds Ratio and Adjusted Odds ratio were calculated. 56% of the participants reported suffering from psychological stress. Results showed that CoT1 had a significant association with somatic stress while CoT1 and CoT2 with cognitive stress. Low CoW and low CoT2 were associated with high psychological stress among middle-level managers while low CoT1 to low psychological stress. The findings indicate that job control have both positive and negative relationships with psychological well-being depending on its dimension. Increasing job control cannot entirely ensure the psychological well-being of employees. Therefore, organisations need to assess different dimensions of job control carefully before providing work flexibility to employees.

Modified work–rest schedule of the handloom weavers

BACKGROUND: A sustainable work schedule is created by employing proper work and recuperation cycles, as well as balancing high- and low-effort tasks. The work of the handloom weaver was physically and mentally taxing. However, they do not take breaks and work nonstop. Short breaks are good for both physical work and job-related mental and cognitive stress. Therefore, a quick break is used as an intervention. METHODS: Participants in this study included 100 handloom weavers. A modified work–rest plan consists of 50 min of labor and 10 min of rest per hour. To order to calculate Brouha's index, recovery heart rate data were collected after work for 3 min while the participant was seated. Using the flicker-fusion frequency test, visual tiredness was assessed. RESULTS: A newly developed work–rest cycle lessens tiredness and becomes more effective over time. The newly created work–rest plan for the handloom weavers dramatically reduces perceived exertion and energy expenditure. CONCLUSION: The modified work–rest schedule decreased cardiovascular and mental stress. This work–rest schedule will therefore reduce fatigue and help with the work if it is used in this sector.

DOES TIME MATTER? A MULTIMODAL ANALYSIS OF SI FROM L2 TO L1

Simultaneous interpreting is regarded as one of the most difficult and stressful types of activity. Simultaneous interpreters work in a severe time deficit and have to absorb much information per unit of time, which means that different cognitive processes (e.g., memory, attention, thinking, perception) are engaged concurrently. This leads to a severe cognitive load, which is sometimes compared with that of pilots. In the current study we investigate how the increase in cognitive load, which happens throughout time, affects interpreters’ performance. This surge, we expect, will be observed on two language levels: verbal and nonverbal (gestural). The analysis is based on 10 videos of simultaneous interpreting of a lecture about biodiversity from English (L2) into Russian (L1), approximately 10 minutes each. The results of the study show an increase in speech disfluencies on the verbal level and distribution of various gesture functions on the nonverbal level. In particular, verbal disfluencies are exteriorized in fillers, draggings and truncations, and their number increases during the interpreting. Along with disfluencies we observed the rise of the co-speech gestures, e.g., adapters and pragmatic gestures, that help maintain control over the process of simultaneous interpreting, structure the output and reduce the cognitive load and stress experienced by participants while performing the task.